Improved
6112 HealthChanged
3786 LivesSaved
3568 Lives1 lives impacted in the last 24 hrs Learn More
A pap smear should be part of every woman's annual health exams. But what happens when a routine test returns results that aren't routine? Dr. Jennifer Wu, an OB/GYN at Lenox Hill Hospital in New York, explains how to deal with word that you've had an abnormal pap smear.
Hi. I'm Denise Richardson, for howdini.com. If you're a woman who takes care of her health, you probably get a Pap smear once a year. Usually, of course, everything's normal. But sometimes we hear that we've had an abnormal Pap smear. How serious is it? Here to help us understand abnormal Pap smears is Dr. Jennifer Wu. What is a Pap smear? And then let's talk about abnormal ones.
So, a Pap smear is a screening tool. Basically, it's a brush across the surface of the cervix, and it collects cells, which are then analyzed. Most doctors are using a liquid-based, versus the old microscopic slides, because it's more accurate. And occasionally you can get some abnormal cells there. What we're really trying to determine is whether there are any precancerous or cancerous cells there.
I associate an abnormal Pap smear with a doctor saying to me you have cancer. Is that the only possibility?
Basically, an abnormal Pap smear means that there are atypical cells there, or abnormal cells there. And you can get abnormal cells if you have a very bad yeast infection, or inflammation in the vagina. One way to help differentiate whether an abnormal cell may lead to cancer is whether HPV is present or not. So most of the time, when a mild abnormality comes back, there will also be an HPV test with it. And it'll tell the doctor, OK, there's a mild abnormality, and HPV is present. Then the doctor will likely go on to more extensive testing.
What kind of testing is that person going to undergo?
It's probably going to be a colposcopy, which is a test using a colposcope, which gives a magnified view of the cervix. So the gynecologist is looking at the cervix on a magnified view, and paints the cervix with some acetic acid. I know it sounds terrible, but it doesn't burn, and it doesn't hurt. And the acetic acid will turn abnormal cells white. So then the gynecologist will likely take pinch biopsies from those sites.
And there must be ranges of abnormal readings.
There are. There are. The mildest of abnormality is atypical squamous cells of undetermined significance. It's when you have these atypical cells plus HPV that you're concerned that there actually could be a precancerous lesion there. More serious abnormalities involve LGSIL and HGSIL, which are low-grade lesions or high-grade lesions. Basically the progression is atypical cells, low-grade lesions, high-grade lesions, and then cancer.
Low-grade lesions. Treatment for that.
Often, in young healthy patients, with a normal immune system, low-grade lesions will go away on their own.
And the next step would be--
High-grade lesion.
High-grade lesion. And treatment for that.
Usually if patients have high-grade lesions, then you may want to do an excisional biopsy, meaning taking out that portion of the cervix that looks abnormal. To certain populations of patients you may not want to be so aggressive. Like a very young patient, a teenager, you probably don't want to take out part of their cervix, if at all possible.
And once you say cancer.
Well, when it's cervical cancer, there are various treatments available for that, also. They can be surgical and radiation.
Do people make mistakes in the readings?
Oftentimes Pap smears can miss certain lesions, or the readings can be a little bit ambiguous. Usually patients who go yearly for checkups, we will catch anything before it becomes cancer.
But if it's ambiguous, do you continue to test, or do you say let's wait it out to see if it changes in six months?
Oftentimes we'll just follow these Pap smears to see that it doesn't seem to progress on to a higher-grade lesion. So patients with abnormal Paps may then need Pap smears every four to six months for a while, to make sure that they're not developing into a higher-grade lesion.
Dr. Wu, thank you. I'm Denise Richardson, for howdini.com.
Howdini is life’s little instruction manual, in HD. We’re all about bringing together the top, most respected experts in their fields to help us be the best we can be at all of the little and not-so-little challenges of our complicated lives. Howdini is the place to be for the know-how you want, when you need it. Or maybe it’s the know-how you need, when you want it. Whatever. We’re here to help. So come in and look around, won’t you?
We think you’ll love finding everything you want to learn about in one convenient place, and as we grow and add more categories and more Howdinis, you’ll be doing less surfing and more learning right here. And unlike television, Howdinis aren’t limited by time—we don’t have to break for commercials, and we’re always on.
Who is Howdini?
People often ask us, is there an actual person who is Howdini? And the answer is, it’s kind of like Lassie. Just as there were many Lassies, there are many individuals who are called Howdini. In fact, each of our experts is a Howdini, and, like all those Lassies, they really know their tricks. (Although so far there is no ‘How to tell your master that Timmy is trapped in the old abandoned mine’ segment)
Our gurus are people you know and trust because you’ve been getting advice from them for years, at places like Good Morning America, The Today Show, Money, Prevention, and Food and Wine (to name just a few). Many are best-selling authors. Others, like our medical experts, are respected leaders in their fields.
Howdini History
The first Howdini was Joanna Breen, who left a comfortable career at ABC’s 20/20 to create a how to video website after one too many frustrating experiences with handymen who weren’t that handy. Joanna had traveled the world reporting with Barbara Walters and others on injustice, outrage, and tragedy, but now it was time to turn her talents to dealing with crises closer to home, like what do you do if you drop your diamond ring down the drain. Joanna is the quintessential can-do girl, so she didn’t find the prospect of launching a gigantic website the least bit daunting. (Ok, that last part isn’t entirely true.)
Joanna convinced an old ABC News buddy, Shelley Lewis, to join her. Shelley had supervised roughly 9.7 million helpful how to segments during a long career executive producing television shows like Good Morning America and CNN’s American Morning. A self-described “info-pig” who loves all kinds of information programming, she is never happier than when she’s learning an amazing new tip that she can annoy share with everyone she knows. Needless to say, Howdini was a dream gig for her. A career woman, a wife, a mother, and author of two books, Shelley considers herself equally challenged by all the facets of her life.
Joanna and Shelley were introduced to marketing executive Alison Provost by a mutual friend who knew that Alison had what they needed - entrepreneurial experience, patience, and a checkbook that still had checks in it. Joanna and Shelley could see right away that Alison should join Howdini. They figured that they would take care of the programming, and Alison would bring trustworthy sponsors to help pay the bills. It took Alison significantly longer to be convinced, maybe because she was crazy busy running a marketing firm called PowerPact, which she continues to oversee while serving as the biggest of big cheeses at Howdini. But whether it’s playing Suduko or launching a new business in a field she knows little about, Alison loves the challenge of a good puzzle, It wasn’t long before she began dropping obscure internet terms like “user-interface” and “googlebot” into casual conversation.
What’s Next for Howdini?
Our goals are modest. Complete and total domination of the internet, crushing Google, Microsoft, and any other punks who get in our way. (Hey, it’s a just a goal.) But until then, we will content ourselves making the best, most professional, most credible how to videos you can find anywhere. We want to help you solve your career issues, your parenting problems, your money troubles. We want you to be more glamorous, healthier, and less stressed out. We want you to check Howdini every day for fun, interesting, useful advice from experts you know and trust.
We want to make Howdini the community you love to be part of every day, To do that, we need to hear from you. Please share your suggestions, rate and comment on the Howdini videos, and the blog, (The Howdini blog). Tell us what you’d like us to create for you.
And then, when we’ve achieved that, it’s back to working on complete and total domination of the internet.
Add a CommentComments
There are no comments yet. Be the first one and get the conversation started!